Elevated Pulse Wave Velocity In Highly Sedentary Endometrial Cancer Survivors: A Call For Future Interventions

BACKGROUND: Endometrial cancer survivors (ECS) experience high incidence of cardiovascular disease (CVD). Unhealthy 24-hour activity behaviors (24-ABs), including high amounts of sedentary behavior (SB), low moderate-to-vigorous physical activity (MVPA) and poor sleep, may contribute to CVD risk in ECS. Pulse wave velocity (PWV) is a non-invasive assessment of arterial stiffness, which is an indicator CVD risk. However, associations between 24-ABs and arterial stiffness in ECS are unknown. Interventions targeting 24-ABs to reduce CVD risk in ECS are needed but simultaneously changing multiple 24-ABs is not feasible. PURPOSE: Therefore, the purpose of this study is to investigate 24-ABs and CVD risk in ECS to inform intervention development. METHODS: Stage 1 ECS (<12 months post-treatment, BMI ≥ 25.0 kg/m2, 50-80 years old) were recruited. Oscillometric PWV was measured via Mobil-O-Graph. Body composition (% fat) was measured via Bioelectrical Impedance Analysis. Accelerometry was used to measure 24-ABs for 7-days. Participants were categorized as highly sedentary if they spent >50% of the 24-hour day engaging in SB. Linear regression was used to compare 24-ABs and PWV.7.3 m/s was used as an age-matched hypertensive referent value. RESULTS: Nineteen ECS (63% White, 21% Black, 5% Asian, 11% American Indian, 63 ± 7 years old, 6 ± 4 months post-treatment, 44 ± 6% body fat) participated in the study. Highly sedentary ECS (N = 11, MVPA: 144 ± 123 min., and sleep: 8 ± 2 hours) spent 13.8 ± 1.6 hours sedentary. Less sedentary ECS (N = 8, MVPA: 216 ± 159 min., and sleep: 8 ± 1 hours) spent 11.3 ± 1.9 hours sedentary. Highly sedentary ECS had higher PWV compared to those who engaged in less SB (0.6 ± 0.8 m/s, R = 0.21, R2 = 0.05, F = 0.86, p < 0.001). There were no differences in age, body fat %, time since treatment, MVPA, sleep or bout length between groups. DISCUSSION: Overall, ECS engage in concerning amounts of SB and PWV was elevated compared to normative data despite achieving recommended amounts of MVPA and sleep. Highly sedentary ECS have increased PWV compared to less sedentary ECS, yet the difference is below the clinically relevant 1 m/s threshold. All ECS were sedentary with elevated PWV. Therefore, future interventions for ECS should focus on strategies to improve intensity or duration of SB interruption. This work was supported by the National Cancer Institute. Lauren C. Bates-Fraser is supported by the National Cancer Institute's National Research Service Award sponsored by the Lineberger Comprehensive Cancer Center at the University of North Carolina (T32 CA116339).